Objective To evaluate the function of peripheral vessels, the change of ankle-brachial Index (ABI) and toe-brachial Index (TBI), and its related risk factors in elderly type 2 diabetic patients were observed. Methods Doppler frequency spectrum was used on lower limb of 128 type 2 diabetic patients and 103 non-diabetic people. ABI and TBI were calculated, other indexes including body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), hypersensitivity C-reactive protein(hs-CRP), triglyceride (TG), total cholesterol (TC), high density lipopretein (HDL), low density lipoprotein (LDL), fasting blood glucose(FBG), postprandial blood glucose (PPBG) and glycosylated hemoglobin (HbAlC) were measured. Results ABI and TBI were decreased in T2DM group as compared with control group (P<0.05), and hs-CRP was increased in T2DM group. With multiple stepwise regression, it showed that ABI and TBI was negatively related with age, SBP and T2DM duration, while ABI was positively correlated with HDL. In multiple logistic regression, cigarette, age, high blood pressure(HBP) and T2DM duration were independent risk factors with respective odds ratios of 1.94 (P<0.05), 2.12(P<0.01), 2.74(P<0.05) and 1.59(P<0.05), respectively. Conclusion Older age, T2DM duration, ciga-rette, hyperglycosema, HBP, low HDL and high bs-CRP play important roles in the occurrence and development of peripheral vascular dis-ease (PVD) in elderly type 2 diabetic patients. PVD of type 2 diabetic patients can be found earlier with Doppler diagnostic instrument.

Objective:Based on the survey of qualitative and quantitative on rural doctors in 6 provinces and cities in China , this paper aimed to compare the present situation of construction of rural doctors under the new health care reform and explore the impact of the new health care reform as well as to propose some suggestions . Methods:Based on the survey of questionnaire and in -depth interviews on rural doctors in 6 provinces and cities in China .Results:The problems existed for rural doctors in China such as insufficient number of personnel , ag-ing, lack of young rural doctors supplement , low level the requirements and situation of professionalism , etc.Con-clusion:It should accelerate the process of the cultivation of rural doctors , promote the education level of rural doc-tors, gradually ease the current situation of the rural doctor shortage .

This paper summed up the medical professionalism as taking patients'interests first , reshaping the medical good faith , improving business ability and promoting social justice .Also proposed that in order to have rea-sonable human resource allocation , ensure the construction of rural health personnel team and stability , the follow-ings are necessary:medical staff at villages and towns setting up the medical ethics , strengthening the altruism spir-it;changing the traditional model of the doctor -patient relationship , adhering to the principle of patient autonomy;cultivating professional sense of responsibility , building moral education;intensive training and striving to improve the level of medical technology;increasing the doctor -patient communication , restoring patients'interests first , re-shaping medical doctor -patient trust integrity , improving business ability and promoting social justice as well as fully exerting the social , moral and cultural supporting factors etc .

Objective: To explore the correlation between serum level of high molecular weight adiponectin (HMW-ADPN) and arteriosclerosis. Methods: Clinical data of 87 middle-aged and aged people living in home, who underwent health examinations in Xiangya second hospital from Jan 2011 to Dec 2011, were collected. According to carotid-femoral pulse wave velocity (cf-PWV) = 9 m/s, they were divided into group A (cf-PWV<9 m/s, n=21) and group B (cf-PWV≥9 m/s, n=66). Blood pressure, blood lipid, blood glucose etc. were measured and compared between two groups. Results: Compared with group A, there were significant rise in blood pressure, levels of low density lipoprotein cholesterol, triglyceride and total cholesterol, and significant reduction in levels of high density lipoprotein cholesterol (HDL-C), serum total ADPN and HMW-ADPN in group B, P<0.05 or <0.01. Multiple regression analysis indicated that serum HMW-ADPN (B= - 4.469，P=0.011), total ADPN ((B= - 3.965，P=0.012), HDL-C（B= - 2.077，P=0.015) and systolic blood pressure levels (B= 0.045，P=0.045) were independent predictors of cf-PWV. Conclusion: Serum high molecular weight adiponectin and total adiponectin levels may be protective factors against arteriosclerosis. Its role in predicting occurrence and development of arteriosclerosis is worthy of further study.

Steroid-induced avascular necrosis of the femoral head (SANFH) is the death of the femoral head caused by long-term use of glucocorticoid (GC). Its pathological manifestations are mainly trabecular bone collapse and increased empty bone lacunas, osteocyte apoptosis rate and autophagy rate. Its pathogenesis is complicated, and the exact pathogenesis is still unclear. MicroRNAs (miRNAs) are a group of endogenous, non-coding small RNAs with an average length of 23 nucleotides. They are responsible for negatively regulating gene expression after transcription by inhibiting target messenger RNAs (mRNAs). MiRNAs play an important role in physiological processes, including cell development, proliferation, differentiation, metabolism, migration and apoptosis. According to bioinformatics analysis, MiRNAs play an important role in regulating gene expression, and it is estimated that more than one-third of human genes are regulated by them. In the past few years, more and more miRNAs have been found to be related to osteonecrosis, such as regulating the proliferation and differentiation of mesenchymal stem cells and osteoblasts. This article aims to review the relationship between steroid-induced femoral head necrosis and miRNAs.